MODULE \ Food-borne Diseases Diploma Program For Health Extension Workers Negga Baraki, Abera Wodajo, Mussie Abera, M.D.; Lemessa Oljira, Habtamu Mitiku, Seyoum Mengistu, M.D.; Fekade Ketema Haramaya University In collaboration with the Ethiopia Public Health Training Initiative, The Carter Center, the Ethiopia Ministry of Health, and the Ethiopia Ministry of Education 2005 Funded under USAID Cooperative Agreement No. 663-A-00-00-0358-00. Produced in collaboration with the Ethiopia Public Health Training Initiative, The Carter Center, the Ethiopia Ministry of Health, and the Ethiopia Ministry of Education. Important Guidelines for Printing and Photocopying Limited permission is granted free of charge to print or photocopy all pages of this publication for educational, not-for-profit use by health care workers, students or faculty. All copies must retain all author credits and copyright notices included in the original document. Under no circumstances is it permissible to sell or distribute on a commercial basis, or to claim authorship of, copies of material reproduced from this publication. ©2005 by Negga Baraki, Abera Wodajo, Mussie Abera, M.D.; Lemessa Oljira, Habtamu Mitiku, Seyoum Mengistu, M.D.; Fekade Ketema All rights reserved. Except as expressly provided above, no part of this publication may be reproduced or transmitted in any form or by any means, electronic or mechanical, including photocopying, recording, or by any information storage and retrieval system, without written permission of the author or authors. This material is intended for educational use only by practicing health care workers or students and faculty in a health care field. ACKNOWLEDGEMENT The authors wish to thank the EPTHIT-Carter Center for their financial, technical and moral support, without which this task would have been very difficult to realize. We are especially grateful to Ato Aklilu Mulugeta, the business manager, and Dr. Hailu Yeneneh, technical advisor at the Carter Center, EPHTI, Addis Ababa Office. W/t Tinebeb, W/t Hiwot and W/t Bruktawit who unwearyingly typed and retyped the document also receive our heart-felt appreciations. Moreover, our gratitude also goes to Ato Haji Kedir, Ato Jemal Seid, W/t Eriteria Tadesse and Ato Lakemariam Kassa from the Faculty of Health Sciences, Alemaya University who reviewed the whole document and suggested valuable comments which lifted the document to its present level. Moreover, the authors would like to express their gratitude to the following National and International reviewers whose comments helped to bring the module to its present shape: Dr. Teklemariam Ayele, Dr. Aberra Geyid, Dr. Troy A Jacobs and others whose names are not mentioned here.Last but not least the authors are also gratefull to the Alemaya University in general and particularly to Professor Desta Hamito – the President and Dr. Belay Kassa – the vice President of Academic and Research for their courageous attention and unreserved support in the production of modules suggested by the initiative. i TABLE OF CONTENTS TOPIC PAGE ACKNOWLEDGEMENT ............................................................................................ i TABLE OF CONTENTS ............................................................................................ ii UNIT ONE-INTRODUCTION .................................................................................... 1 1.1 Purpose and use of the Module ........................................................................ 1 1.2 Directions for using the Module ......................................................................... 2 UNIT TWO-CORE MODULE FOR THE HEALTH CENTER TEAM .......................... 3 2.1 Pre-test .......................................................................................................... 3 Part I: Questions for all categories ....................................................................... 3 Part II: Questions for the specific categories ........................................................ 4 2.2 Significance and brief description of food borne diseases ............................. 8 2.3 Learning Objectives ....................................................................................... 9 2.4 Case Study .................................................................................................. 10 2.5 Definition of food borne diseases ................................................................. 11 2.6 Epidemiology of food borne diseases .......................................................... 11 2.7 Classification and Etiology of some food borne diseases ............................ 12 2.8 Pathogenesis and clinical features of some food borne disease .................. 16 2.8.1 Food-borne Infections ...................................................................... 16 2.8.2 Food poisonings/intoxications .......................................................... 23 2.9 diagnosis of food-borne diseases ................................................................ 26 2.10 General management approaches of food-borne diseases ....................... 29 2.11 Prevention and control of food-borne diseases .......................................... 29 2.12 Investigation of outbreaks of food-borne diseases ..................................... 32 UNIT THREE-SATELLITE MODULE FOR THE DIFFERENT CATEGORIES OF THE HEALTH CENTER TEAM AND HEALTH EXTENSION WORKERS ............. 35 ii 3.1 SATELLITE MODULE FOR PUBLIC HEALTH NURSES ............................ 36 3.2 SATELLITE MODULE FOR ENVIRONMENTAL HEALTH TECHNICIANS . 44 3.3 SATELLITE MODULE FOR MEDICAL LABORATORY TECHNICIANS ...... 59 3.4 SATELLITE MODULE FOR HEALTH EXTENSION WORKERS ................. 69 3.5 TAKE HOME MESSAGES FOR CARE GIVERS/SELF-CARE .................... 87 UNIT FOUR-TASK ANALYSIS FOR THE DIFFERENT HEALTH TEAM MEMBERS .......................................................................................... 89 UNIT FIVE-ABBREVIATIONS AND GLOSSARY .................................................. 93 Abbreviations .................................................................................................. 93 Glossary ......................................................................................................... 94 ANNEXES ............................................................................................................... 96 BIBLIOGRAPHY ................................................................................................... 108 iii UNIT ONE INTRODUCTION 1.1. Purpose and Use of the Module A big challenge in the training of well-versed health professionals in the different higher institutions in Ethiopia has emanated from the serious shortage of adequate number of contextual reference materials. To add to this problem, even the available reference materials sometimes fail to address the most important learning issues of the Ethiopian students as well as being not suitable enough for their learning styles. However, up to this day, efforts geared towards the preparation of reference materials by instructors in the different institutions in order to reduce this problem have remained meager. This brings into picture the purpose of the preparation of this module, which is just one among many having been or being undertaken through the initiation made by the Carter Center, EPHTI. This module is prepared to help students develop knowledge, attitudes and skills required in their practice areas through active learning. To this end, it will enable the different members of the Ethiopian health center team; included in this module are, Public health Nurse (PHN), Environmental Heath Technician (EHT), and Medical Laboratory Technician (MLT), to be able to recognize and manage the important food-borne diseases as well as to prevent them from occurring from the outset. Moreover this module also contains a satellite for Health Extension Workers (HEW) who are expected to play a pivotal role in alleviating the prevalent health problems of the country. Besides, it is believed that those already engaged in the service delivery in different health facilities will benefit well from reading to this module from time to time. All individuals taking time to look at this document are reminded of the importance of consulting standard textbooks on the subject whenever possible, since this module is by no means meant to replace them. 1 1.2. Directions for Using the Module Before starting to read this module, please follow the directions given below: 1. Go through all the contents of the core module by starting with the pretest. 2. Use a separate sheet of paper to write your answers and label it “pretest answers”. 3. The pretest has two portions: Part I, and Part II. PART I: Contains common questions to be answered by all categories of the health center team. PART II: The questions are prepared for the specific categories; Health Officers, Nurses, Environmental Health Officers, and Medical Laboratory Technologists. Select and do the portion that corresponds to your professional category. ¾ When you are sure that you are through the core module proceed to read the satellite module corresponding to your profession or interest. ¾ Go through the task analysis for the team members in comparison with that of your own. Note: You may refer to the list of abbreviations and glossary shown in Unit Seven for terms that are not clear. 2 UNIT TWO CORE MODULE FOR THE HEATH CENTER TEAM MEMBERS 2.1. Pre-test Write the answers of the following questions on a separate